Most Relevant Information
Provider Data
| NPI Number: | 1003407685 |
| Provider Name: | NICHOLAS PAUL REYES |
| Entity Type: | Individual |
| Taxonomy Code: | 2255A2300X |
| Specialty: | Specialist/Technologist |
| License Number: | 2000005272 |
Most Important Dates
| Enumeration Date: | 01/27/2021 |
| Last Updated: | 01/27/2021 |
Provider Practice Location
1201 S CLEARVIEW PKWY
JEFFERSON
LA
701211015
Practice Location Phone/Fax
| Phone: | 5048424348 |
| Fax: |
Provider Mailing Location
1201 S CLEARVIEW PKWY
JEFFERSON
LA
701211015
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |